NPIMap

Organization Active NPI

Midwest Recovery Center LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Toledo, OH
National Provider Identifier
1407326366
Registry record updated Mar 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
MIDWEST RECOVERY CENTER LLC
Practice address
4747 Monroe St
Toledo, OH 43623-4307
Phone
(866) 203-0308
NPI assigned
Dec 4, 2018
Organization subpart
Yes
Parent organization
MIDWEST RECOVERY CENTER, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 11, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Kim Brown
Title
Director of Compliance
Phone
(870) 243-7219

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X Primary

Addresses

Primary practice location

4747 Monroe St
Toledo, OH 43623-4307

Mailing address

10461 Mill Run Cir Ste 810
Owings Mills, MD 21117-5549
Phone (832) 240-3024

Other practice location 1

115 W State St
North Baltimore, OH 45872-1332
Phone (419) 216-2888

Other practice location 2

6629 W Central Ave
Toledo, OH 43617-1098
Phone (866) 628-0301

Other practice location 3

7540 New West Rd
Toledo, OH 43617-4200
Phone (866) 688-6917

Other identifiers 2

IdentifierTypeStateIssuer
0326341MedicaidOH
0309004MedicaidOH

National Provider Directory

National Provider Directory
Tax ID family
Midwest Recovery Center LLC3 organizations share this tax ID, including this one
Part of
Midwest Recovery Center LLC

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

6629 W Central Ave
Ste A
Toledo, OH 43617
Phone (567) 268-4226

7540 New West Rd
Toledo, OH 43617
Phone (833) 440-8648

Practitioners & affiliated clinicians

Practitioners 122

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 122

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1543881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710115200000",
    "number": "1407326366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10461 MILL RUN CIR STE 810",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211175549",
            "telephone_number": "832-240-3024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4747 MONROE ST",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436234307",
            "telephone_number": "866-203-0308"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "115 W State St",
            "address_purpose": "LOCATION",
            "city": "North Baltimore",
            "state": "OH",
            "postal_code": "458721332",
            "country_code": "US",
            "telephone_number": "419-216-2888",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6629 W Central Ave",
            "address_purpose": "LOCATION",
            "city": "Toledo",
            "state": "OH",
            "postal_code": "436171098",
            "country_code": "US",
            "telephone_number": "866-628-0301",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7540 New West Rd",
            "address_purpose": "LOCATION",
            "city": "Toledo",
            "state": "OH",
            "postal_code": "436174200",
            "country_code": "US",
            "telephone_number": "866-688-6917",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MIDWEST RECOVERY CENTER LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MIDWEST RECOVERY CENTER, LLC",
        "enumeration_date": "2018-12-04",
        "last_updated": "2024-03-11",
        "certification_date": "2024-03-11",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "KIM",
        "authorized_official_title_or_position": "DIRECTOR OF COMPLIANCE",
        "authorized_official_telephone_number": "870-243-7219"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0326341",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0309004",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.